PFS Credit Balance Representative - 40 hrs/wk, 1st shift

PURPOSE OF THIS POSITION

The Credit Balance Representative analyzes posted transactions to determine why there is a credit balance. This position requires detailed analysis and critical thinking to determine what is necessary to correct the account. After review, if a refund is appropriate to either the patient or insurance company, a payment transfer is necessary, or a reversal or correction of contractual allowance or an administrative adjustment is warranted, the representative is responsible to correct the postings and/or refund the overpayment to the correct payer(s).

Job Duties/Responsibilities

• Duties 1-8
• Duty 9. Maintains a thorough understanding and education of federal and state regulations and payer specific policies and requirements to promote compliant credit and collection practices. Adheres to HIPAA related privacy, security and transaction & code set regulations in compliance with the federal guidelines. Accurately documents all account activity.
• Duty 10. Regularly attends and actively participates in staff meetings, in-service, and continuing education programs as offered. Assists in other duties and projects as needed assigned by the supervisor and/or manager.

Required Qualifications

• High school graduate or GED equivalent
• Certified Patient Financial Services Specialist certificate to be completed within 12 months of hire date
• 2-3 years of experience in medical billing and collections, or satisfactory completion of internal billing/self-pay billing assessment
• Excellent written and verbal communication with positive oriented interpersonal skills
• Knowledge and experience with Microsoft office products and Window PC functionality
• Individual must be able to demonstrate the knowledge and skills necessary to provide care appropriate to the age of the patient served on his/her assigned unit/department

Preferred Qualifications

• Degree in healthcare administration or related field, and/or relevant work experience
• Medical terminology ICD 10 and/or CPT coding knowledge